Head Injury Due to Fall from Heights in Pediatric Population of a Middle Resource Country

Abstract

Objective:  One of the serious concerns for public health is unintentional injuries. Falls rank as the second most common cause of unintentional injury deaths globally, after injuries sustained in transportation accidents. The study's goals were to check the mechanisms and severity of the head injury from falls among children.

Materials and Methods:  A non-randomized retrospective study was conducted and children aged 0 – 12 years (n = 228) undergoing cranial CT guidance for head injury were enrolled. All patients were treated under the supervision of the neurosurgery department. Detailed radiological evaluation was done and recorded on specialized proforma.

Results:  Among the enrolled patients, mild head injury was noted in 49.1% of children while moderate head injury was noted among 40.4% of children. A total of 72 (31.6%) patients had skull fractures, of which 12 (5.3%) had a thin underlying subdural hemorrhage. Four cases of extradural hemorrhage complicated a skull fracture, and eight cases of isolated Subdural hemorrhage (SDH) were observed without a skull fracture. Of those 48 (21%), radiologically evident diffuse axonal injuries were present, and each of them included high-force injury mechanisms.

Conclusion:  When children sustain minor trauma, skull fractures, and focal SDH are rather common, although most of the time there are no long-term neurological effects. On the other hand, patients with an equally severe cause of injury were the only ones who experienced diffuse brain injury with significant neurological disability that followed.